NPIMap

Individual provider Active NPI

Lawrence M Goldyn, M.D.

  • Adult Medicine Physician
  • Fort Bragg, CA
National Provider Identifier
1780605097
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
G67575 Issued in CA
Practice address
205 South St
Fort Bragg, CA 95437-5540
Phone
(707) 964-1251
Fax
(707) 961-2722
NPI assigned
Jul 21, 2006
Last updated
Feb 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X G67575 CA Primary

Addresses

Primary practice location

205 South St
Fort Bragg, CA 95437-5540

Mailing address

205 South St
Fort Bragg, CA 95437-5540
Phone (707) 964-1251

Other identifiers 1

IdentifierTypeStateIssuer
FCH03967FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061013000269 CA Practitioner - Internal Medicine 1557367588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendocino Coast Clinics, IncGroup PAC ID 5991619157, 19 clinicians

Practice addresses (Care Compare)

205 S St
Fort Bragg, CA 95437-5540
Phone (707) 964-1251

333 Laws Ave
Ukiah, CA 95482-6540
Phone (707) 468-1010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as group
Quality
81.89
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mendocino Coast Clinics Inc CurrentSince Jul 1, 2006 Accepting new patients
Mendocino Coast Clinics, Inc. CurrentSince Jul 1, 2006 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Feb 2, 2013 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Feb 2, 2013 Accepting new patients
Mendocino Coast Clinics Inc Current Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Strategic Wellness Inc PastSince Oct 27, 2019 Accepting new patients
Adventist Health Mendocino Coast Past Accepting new patients
Mendocino Community Health Clinic, Inc. Past Accepting new patients

Locations

205 South St
Fort Bragg, CA 95437
Phone (707) 961-4088

333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113

45 Hazel St
Willits, CA 95490
Phone (707) 456-9600

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lawrence.goldyn.p1@direct.mccinc.nextgenshare.com
  • Direct secure messaging: lgoldyn335481@direct.ochin.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1780605097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375540",
            "telephone_number": "707-964-1251",
            "fax_number": "707-961-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375540",
            "telephone_number": "707-964-1251",
            "fax_number": "707-961-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDYN",
        "first_name": "LAWRENCE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "G67575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FCH03967F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

Verify at the official NPI Registry.